Wellness & Resiliency

CHARM

The Collaborative for Healing and Renewal in Medicine (CHARM) is a group of medical educators, leaders at academic medical centers and experts in burnout research and interventions designed to promote learner wellness, which is formed with the support of the Alliance for Academic Internal Medicine (AAIM).CHARM’s mission is to gather best practices; promote investigation of the impact of learner burnout; develop tools for educators to address learners in distress; and advocate for the recognition and inclusion of initiatives that foster well-being among learners. 

Collaborative Learning Communities are mutually beneficial and well defined groups with a commitment to shared goals, resources and responsibility and managed through collective authority and accountability.

Steering Group

  • Hasan Bazari, MD, Co-Chair
  • Jonathan Ripp, MD, Co-Chair
  • Kelly J. Caverzagie, MD
  • Susan Hingle, MD
  • Diana B. McNeill, MD
  • Mukta Panda, MD
  • Larissa Thomas, MD
  • Oana Tomescu, MD
  • Mariah Quinn, MD
  • Colin P. West, MD, PhD
  • Gopal Yadavalli, MD

Faculty Development/Tool Kit Subgroup

  • Lead: Mukta Panda, MD
  • Initial Deliverable: Development of toolkit with content and curricula to train medical educators in establishing wellness programs at their own institution and  and dissemination at national conferences.
  • Progress:
    • Workshop presentations at the 2016 AAIM Skills Development Conference entitled “The Fourth Aim: A Toolkit for Medical Educators to Develop Resilience, Maintain Professional Satisfaction and Restore Joy to Teaching and Medical Practice.” Will present workshop at the 2017 Academic Internal Medicine Week and 2017 SGIM Annual Meeting.
    • Three modules actively in progress: Creating Learning and Practice Environments that Support Resilience: Tips to engage and communicate with institutional leadership (elevator speech), Promoting a Culture of Trainee Well-Being: The creation of safe and trustworthy spaces, and Enhancing personal awareness.
  • Additional Plans for 2017: During the development of this curriculum, it became clear that there were numerous other topics worth covering. The group is beginning the process of developing 13 separate modules with themes such as How to engage leadership on the importance of wellness programs, How to promote a culture of trainee well-being?,Numerous Individual-level wellness practices, and Wellness study research methodology.
  • Challenges: Finding the appropriate platform for making all of these modules "open access".

Best Practices Subgroup

  • Lead: Oana Tomescu, MD
  • Initial Deliverable: Creation of a detailed repository of (EBM) best practices to address learner/resident well-being and burnout
  • Progress: This initial deliverable has grown and expanded into the concept of an "annotated bibliography" of best practices, which is nearing completion and could be the framework of a systematic review.
  • Additional Plans for 2017: At a minimum this will be presented at the Society of General Internal Medicine Annual Meeting. Additionally, the group will work to have this published in the literature as a narrative review and posted online in an open access format.
  • Deliverable to share: Best Practices: Annotated Bibliography of Evidence Based Well-Being Interventions

Research Subgroup

  • Lead: Colin West, MD, PhD
  • Initial Deliverable: Plans for a multi-center inter-institutional resident well-being and distress research platform including proposal for an initial study and exploration of potential grant support
  • Progress: Given the enormity of this deliverable, the subgroup chose to first work on a manuscript addressing appropriate research methodology for conducting wellbeing research in learner/trainee populations. This manuscript's initial draft is near completion
  • Additional Plans for 2017: The subgroup will continue to discuss how to launch its research platform
  • Deliverable to Share: "A Roadmap for Research on Resident Well-Being" accepted for JGME publication.

Advocacy/Dissemination Subgroup

  • Lead: Jonathan Ripp, MD and Hasan Bazari, MD
  • Initial Deliverable: Publication of a Consensus Statement
  • Progress: Accepted to Academic Medicine
  • Additional Plans for 2017: Development and dissemination of a "Charter on Physician Well-Being" with multiple professional society endorsements
  • Deliverable to Share: Well-Being in Graduate Medical Education: A Call for Action (published in Academic Medicine, May 2017)

Other Progress to Date

CHARM has been quite successful in forging partnerships with other like-minded groups and organizations. CHARM has made partnerships and has representation within its membership from:

  • The American College of Physicians—currently exploring collaborative development of wellness modules
  • The Arnold Gold Foundation
  • The American Medical Association—CHARM members have added "vignette" content to the existing AMA Steps Forward program
  • The Accreditation Council for Graduate Medical Education—CHARM was well represented at the ACGME's Second Symposium on Physician Well-Being
  • The Society for Hospital Medicine—CHARM members will be presenting a joint workshop with SHM members at Hospital Medicine 2017
  • Growth in membership—over the course of the first year CHARM has expanded to include representatives from community-based and academic institutions, medical student, and graduate level educators and regions of varied geography throughout the US. Members include program directors, associate program directors, fellowship directors, clerkship directors, deans, medical students, trainees, chairs, vice chairs, DIOs, and other faculty members.
  • Partnership with the AAIM Wellness Committee—CHARM leaders were represented on the AAIM Wellness Committee.
  • Need for Ongoing Funding: None of these initial successes would have been possible without the administrative support provided by AAIM Innovation Center. The Collaborative is at a crucial period of growth where it has been recognized for its potential and expertise.  AAIM funding runs until the end of June 2017. At which time, administrative support will be maintained through the Massachusetts General Hospital Swartz Initiative under Dr. Bazari's leadership.